Neurotrauma Registry Implementation in Colombia: A Qualitative Assessment

Abstract

Objectives Latin America is among several regions of the world that lacks robust data on injuries due to neurotrauma. This research project sought to investigate a multi-institution brain injury registry in Colombia, South America, by conducting a qualitative study to identify factors affecting the creation and implementation of a multi-institution TBI registry in Colombia before the establishment of the current registry. Methods Key informant interviews and participant observation identified barriers and facilitators to the creation of a TBI registry at three health care institutions in this upper-middle-income country in South America. Results The study identified barriers to implementation involving incomplete clinical data, limited resources, lack of information and technology (IT) support, time constraints, and difficulties with ethical approval. These barriers mirrored similar results from other studies of registry implementation in low- and middle-income countries (LMICs). Ease of use and integration of data collection into the clinical workflow, local support for the registry, personal motivation, and the potential future uses of the registry to improve care and guide research were identified as facilitators to implementation. Stakeholders identified local champions and support from the administration at each institution as essential to the success of the project. Conclusion Barriers for implementation of a neurotrauma registry in Colombia include incomplete clinical data, limited resources and lack of IT support. Some factors for improving the implementation process include local support, personal motivation and potential uses of the registry data to improve care locally. Information from this study may help to guide future efforts to establish neurotrauma registries in Latin America and in LMICs.

Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries: A scoping review

“…We present the characteristics of the 6 included studies in Table 1 . Of the included studies, 4 were qualitative [ 19 – 22 ], 1 was a cross-sectional survey [ 23 ] and the study by Aluisio and colleagues was described to be an ‘analysis’ [ 24 ]. All included studies were published as full articles.…”

“…The study by Ahmed [ 21 ] included participants from Africa and Latin America; the study by Franzen [ 19 ] included participants from Ethiopia, Cameroon and Sri Lanka. The study by Johnson and colleagues [ 22 ] included participants from Colombia and Sawe’s study [ 20 ] included participants from Tanzania. The study by von Arnim [ 23 ] included participants from Southeast Asia, Latin America, Africa and Eastern Europe.…”

Neurotrauma Registries in Low- and Middle-Income Countries for Building Organized Neurotrauma Care: The LATINO Registry Experience Comment on "Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries"

“…The combination of these perspectives allows this effort to be adaptable to different contexts, like the ones that we found in the Latin America (LATAM) region. 7 In this registry, even centers with fewer resources can participate and transition from a minimal data set to a more complete one as they increase the level of development and support from local administrative authorities. Additionally, to overcome language barriers, the LATINO-TBI registry is available in Spanish, English, and Portuguese, which are the most common languages in the region, with the same internal coding to facilitate cross-country analysis and comparative analysis with other databases.…”

“…The combination of these perspectives allows this effort to be adaptable to different contexts, like the ones that we found in the Latin America (LATAM) region. 7 …”